Melinda C Power1, Andreea Rawlings2, A Richey Sharrett2, Karen Bandeen-Roche3, Josef Coresh4, Christie M Ballantyne5, Yashashwi Pokharel6, Erin D Michos7, Alan Penman8, Alvaro Alonso9, David Knopman10, Thomas H Mosley11, Rebecca F Gottesman12. 1. Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: melindacpower@gmail.com. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 3. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 5. Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 6. Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Saint Luke's Mid America Heart Institute, University of Missouri, Kansas City, MO, USA. 7. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 8. Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA. 9. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 10. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 11. Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA. 12. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
INTRODUCTION: Existing studies predominantly consider the association of late-life lipid levels and subsequent cognitive change. However, midlife rather than late-life risk factors are often most relevant to cognitive health. METHODS: We quantified the association between measured serum lipids in midlife and subsequent 20-year change in performance on three cognitive tests in 13,997 participants of the Atherosclerosis Risk in Communities study. RESULTS: Elevated total cholesterol, low-density lipoprotein cholesterol, and triglycerides were associated with greater 20-year decline on a test of executive function, sustained attention, and processing speed. Higher total cholesterol and triglycerides were also associated with greater 20-year decline in memory scores and a measure summarizing performance on all three tests. High-density lipoprotein cholesterol was not associated with cognitive change. Results were materially unchanged in sensitivity analyses addressing informative missingness. DISCUSSION: Elevated total cholesterol, low-density lipoprotein cholesterol, and triglycerides in midlife were associated with greater 20-year cognitive decline.
INTRODUCTION: Existing studies predominantly consider the association of late-life lipid levels and subsequent cognitive change. However, midlife rather than late-life risk factors are often most relevant to cognitive health. METHODS: We quantified the association between measured serum lipids in midlife and subsequent 20-year change in performance on three cognitive tests in 13,997 participants of the Atherosclerosis Risk in Communities study. RESULTS: Elevated total cholesterol, low-density lipoprotein cholesterol, and triglycerides were associated with greater 20-year decline on a test of executive function, sustained attention, and processing speed. Higher total cholesterol and triglycerides were also associated with greater 20-year decline in memory scores and a measure summarizing performance on all three tests. High-density lipoprotein cholesterol was not associated with cognitive change. Results were materially unchanged in sensitivity analyses addressing informative missingness. DISCUSSION: Elevated total cholesterol, low-density lipoprotein cholesterol, and triglycerides in midlife were associated with greater 20-year cognitive decline.
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